NUR 376
EXAM 4
(Applied Pathophysiology)
Actual Questions with Correct Answers
Concordia University’s
What’s Included:
• EXAM + STUDY GUIDE
• 50+ verified questions with Correct answers
with Rationales.
• Multiple-choice questions
• select-all-that-apply (SATA) questions
• Matching & Sequencing questions
• Ideal for exam preparation and concept reinforcement.
,Table of Contents
NUR 376 EXAM 4 .......................................................................2
NUR 376 EXAM 4 STUDY GUIDE .................................................. 29
NUR 376 EXAM 4
1. A client with newly diagnosed Graves' disease asks the nurse how hyperthyroidism
developed. Which explanation best describes the underlying pathophysiology?
A. The pituitary gland overproduces thyroid-stimulating hormone (TSH).
B. Autoantibodies stimulate the thyroid gland to overproduce T3 and T4.
C. Benign thyroid nodules autonomously secrete excessive thyroid hormone.
D. Iodine deficiency causes compensatory enlargement and overactivity of the thyroid.
Correct Answer: B
Rationale:
Graves' disease is an autoimmune disorder characterized by thyroid-stimulating
immunoglobulins (TSI) that bind to TSH receptors on thyroid follicular cells, triggering excessive
synthesis and release of T3 and T4. This is distinct from TSH-secreting pituitary adenomas (A),
toxic multinodular goiter (C), or iodine-deficiency goiter (D).
2. A nurse is assessing a client with newly diagnosed hyperthyroidism. Which findings are
consistent with this condition? (Select all that apply.)
A. Tachycardia
B. Weight gain
C. Heat intolerance
D. Anxiety
,E. Tremors
F. Goiter
Correct Answer: A, C, D, E, F
Rationale:
Hyperthyroidism increases the basal metabolic rate, producing tachycardia, heat intolerance,
anxiety, fine tremors, and goiter from thyroid enlargement. Weight loss—not weight gain—
occurs due to increased catabolism. Weight gain is characteristic of hypothyroidism.
3. A client with hypothyroidism reports multiple symptoms. Which manifestation requires the
most immediate follow-up by the nurse?
A. Dry skin
B. Constipation
C. Bradycardia
D. Cold intolerance
Correct Answer: C
Rationale:
While fatigue, weight gain, cold intolerance, bradycardia, constipation, and dry skin are all
classic manifestations of hypothyroidism, bradycardia (heart rate <60 bpm) may indicate severe
or advanced myxedema and requires immediate assessment for potential cardiac compromise,
including pericardial effusion or myxedema coma.
4. A parent brings a 12-year-old to the clinic reporting excessive thirst, frequent urination, and
unexplained 10-pound weight loss over 3 weeks. The nurse suspects Type 1 DM based on
which characteristic pathophysiology?
A. Insulin resistance in peripheral skeletal muscle and adipose tissue
B. Autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency
C. Excessive glucagon secretion from pancreatic alpha cells
D. Chronic pancreatitis causing exocrine and endocrine enzyme deficiency
Correct Answer: B
Rationale:
Type 1 diabetes mellitus is an autoimmune disorder characterized by T-cell mediated
destruction of pancreatic beta cells, resulting in absolute insulin deficiency. This produces the
classic presentation of polyuria, polydipsia, polyphagia, weight loss, fatigue, and early onset
(typically <30 years). Type 2 DM involves insulin resistance (A).
, 5. A nurse is reviewing pancreatic endocrine function with a client. Which statement correctly
identifies the cells and their hormonal products responsible for blood glucose regulation?
A. Beta cells produce glucagon; alpha cells produce insulin
B. Beta cells produce insulin; alpha cells produce glucagon
C. Delta cells produce insulin; beta cells produce somatostatin
D. Alpha cells produce somatostatin; beta cells produce glucagon
Correct Answer: B
Rationale:
The islets of Langerhans contain beta cells that secrete insulin (anabolic hormone that lowers
blood glucose by promoting cellular uptake) and alpha cells that secrete glucagon (catabolic
hormone that raises blood glucose via glycogenolysis and gluconeogenesis). Delta cells produce
somatostatin, which modulates both hormones.
6. A client with Type 1 DM is admitted with diabetic ketoacidosis (DKA). Which findings does
the nurse expect? (Select all that apply.)
A. Blood glucose 420 mg/dL
B. Positive ketonuria
C. Metabolic acidosis
D. Fruity breath odor
E. Kussmaul respirations
F. Bradycardia
Correct Answer: A, B, C, D, E
Rationale:
DKA is characterized by hyperglycemia (typically >250 mg/dL), ketonuria from ketone body
production, metabolic acidosis (pH <7.3, HCO3- <18 mEq/L), fruity breath from acetone
exhalation, and Kussmaul respirations (compensatory hyperventilation). Tachycardia—not
bradycardia—occurs due to dehydration, acidosis, and catecholamine surge.
7. A nurse is teaching a client with long-standing Type 2 DM about complications. Which
statement best explains the underlying pathophysiology of diabetic nephropathy, neuropathy,
and retinopathy?
EXAM 4
(Applied Pathophysiology)
Actual Questions with Correct Answers
Concordia University’s
What’s Included:
• EXAM + STUDY GUIDE
• 50+ verified questions with Correct answers
with Rationales.
• Multiple-choice questions
• select-all-that-apply (SATA) questions
• Matching & Sequencing questions
• Ideal for exam preparation and concept reinforcement.
,Table of Contents
NUR 376 EXAM 4 .......................................................................2
NUR 376 EXAM 4 STUDY GUIDE .................................................. 29
NUR 376 EXAM 4
1. A client with newly diagnosed Graves' disease asks the nurse how hyperthyroidism
developed. Which explanation best describes the underlying pathophysiology?
A. The pituitary gland overproduces thyroid-stimulating hormone (TSH).
B. Autoantibodies stimulate the thyroid gland to overproduce T3 and T4.
C. Benign thyroid nodules autonomously secrete excessive thyroid hormone.
D. Iodine deficiency causes compensatory enlargement and overactivity of the thyroid.
Correct Answer: B
Rationale:
Graves' disease is an autoimmune disorder characterized by thyroid-stimulating
immunoglobulins (TSI) that bind to TSH receptors on thyroid follicular cells, triggering excessive
synthesis and release of T3 and T4. This is distinct from TSH-secreting pituitary adenomas (A),
toxic multinodular goiter (C), or iodine-deficiency goiter (D).
2. A nurse is assessing a client with newly diagnosed hyperthyroidism. Which findings are
consistent with this condition? (Select all that apply.)
A. Tachycardia
B. Weight gain
C. Heat intolerance
D. Anxiety
,E. Tremors
F. Goiter
Correct Answer: A, C, D, E, F
Rationale:
Hyperthyroidism increases the basal metabolic rate, producing tachycardia, heat intolerance,
anxiety, fine tremors, and goiter from thyroid enlargement. Weight loss—not weight gain—
occurs due to increased catabolism. Weight gain is characteristic of hypothyroidism.
3. A client with hypothyroidism reports multiple symptoms. Which manifestation requires the
most immediate follow-up by the nurse?
A. Dry skin
B. Constipation
C. Bradycardia
D. Cold intolerance
Correct Answer: C
Rationale:
While fatigue, weight gain, cold intolerance, bradycardia, constipation, and dry skin are all
classic manifestations of hypothyroidism, bradycardia (heart rate <60 bpm) may indicate severe
or advanced myxedema and requires immediate assessment for potential cardiac compromise,
including pericardial effusion or myxedema coma.
4. A parent brings a 12-year-old to the clinic reporting excessive thirst, frequent urination, and
unexplained 10-pound weight loss over 3 weeks. The nurse suspects Type 1 DM based on
which characteristic pathophysiology?
A. Insulin resistance in peripheral skeletal muscle and adipose tissue
B. Autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency
C. Excessive glucagon secretion from pancreatic alpha cells
D. Chronic pancreatitis causing exocrine and endocrine enzyme deficiency
Correct Answer: B
Rationale:
Type 1 diabetes mellitus is an autoimmune disorder characterized by T-cell mediated
destruction of pancreatic beta cells, resulting in absolute insulin deficiency. This produces the
classic presentation of polyuria, polydipsia, polyphagia, weight loss, fatigue, and early onset
(typically <30 years). Type 2 DM involves insulin resistance (A).
, 5. A nurse is reviewing pancreatic endocrine function with a client. Which statement correctly
identifies the cells and their hormonal products responsible for blood glucose regulation?
A. Beta cells produce glucagon; alpha cells produce insulin
B. Beta cells produce insulin; alpha cells produce glucagon
C. Delta cells produce insulin; beta cells produce somatostatin
D. Alpha cells produce somatostatin; beta cells produce glucagon
Correct Answer: B
Rationale:
The islets of Langerhans contain beta cells that secrete insulin (anabolic hormone that lowers
blood glucose by promoting cellular uptake) and alpha cells that secrete glucagon (catabolic
hormone that raises blood glucose via glycogenolysis and gluconeogenesis). Delta cells produce
somatostatin, which modulates both hormones.
6. A client with Type 1 DM is admitted with diabetic ketoacidosis (DKA). Which findings does
the nurse expect? (Select all that apply.)
A. Blood glucose 420 mg/dL
B. Positive ketonuria
C. Metabolic acidosis
D. Fruity breath odor
E. Kussmaul respirations
F. Bradycardia
Correct Answer: A, B, C, D, E
Rationale:
DKA is characterized by hyperglycemia (typically >250 mg/dL), ketonuria from ketone body
production, metabolic acidosis (pH <7.3, HCO3- <18 mEq/L), fruity breath from acetone
exhalation, and Kussmaul respirations (compensatory hyperventilation). Tachycardia—not
bradycardia—occurs due to dehydration, acidosis, and catecholamine surge.
7. A nurse is teaching a client with long-standing Type 2 DM about complications. Which
statement best explains the underlying pathophysiology of diabetic nephropathy, neuropathy,
and retinopathy?
